Lateral ligament injury (rolled ankle)

What is it?
A lateral ligament injury usually refers to a tear of one or more of th ligaments on the outside (lateral aspect) of the ankle. The lateral ligaments consist of three ligament bands which provide stability to the outside of the ankle joint.

How does it occur?
The lateral ligaments are injured when they are overstretched (sprained). This commonly occurs when the foot and ankle are forcibly rolled inwards. The ankle may be rolled during rapid changes in direction, on uneven surfaces, or treading on a ball or opponent's foot.

What you should do:
The most important time in the treatment of any injury is the first 24-48 hours. Swelling is a necessary step in the healing process; however too much swelling can delay healing and cause further tissue damage. To control the amount of swelling and limit the degree of damage to the lateral ligament complex, the RICE regime is recommended.

REST – Involves ceasing your activity or sport and limiting the amount of weight you put through your ankle. Crutches may be required if you are having difficulty walking.

ICE – Should be applied to the injured site for 15-20 minutes every 1-2 hours. Crushed ice wrapped in a moist cloth or towel is most effective.

COMPRESSION – Involves the application of a firm elastic bandage around your ankle. It needs to be tight but not firm enough to cause pain.

ELEVATION – Involves lying with your ankle resting comfortably on a pillow or two so it is above the level of your heart. It is recommended that you continue the RICE regime until you have consulted a sports medicine professional. Ideally, this should be done within 2 days of the initial injury.

What you shouldn't do:
Following injury to the lateral ligament complex you should not undertake any activities that could cause the blood flow to the injury site to increase and therefore cause swelling. These activities include heat rubs, hot showers, alcohol and excessive activity.

Complications:
Most lateral ligament injuries heal without complication within a matter of weeks. However, a percentage of injuries may result in longer-term effects depending on the severity of the injury and the extend of damage. A number of structures in the vicinity of the lateral ligaments may also be damaged when the ankle is rolled. Injuries to these structures can produce persistent pain and swelling which can slow recovery. A wrong diagnosis or poor management of your injury could result in reduced range of movement, weakness and an increased chance of reinjuring the ankle.

Management:
After the initial RICE regime, the aim of physiotherapy treatment is to restore the ankle to it's full function. This involves regaining full range of motion, strengthening the muscles around the ankle, improving balance with specific exercises and graduated return to full activity. Our team of physios will be able to advise you on other preventive measures such as strapping tape or ankle braces.

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